| NPI | 1063837995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA CH60435756) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: WA AC60812877) |
| Enumeration Date | 2014-03-01 |
| Last Update Date | 2024-11-05 |